Severe acute hypertension among inpatients admitted from the emergency department.

MedStar author(s):
Citation: Journal of Hospital Medicine (Online). 7(3):203-10, 2012 Mar.PMID: 22038891Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Emergency Service, Hospital | *Hypertension/ep [Epidemiology] | *Inpatients | Acute Disease | Aged, 80 and over | Aged | Female | Humans | Length of Stay | Male | Medical Audit | Middle Aged | Patient Admission | Prevalence | Retrospective Studies | Severity of Illness Index | United States/ep [Epidemiology]Year: 2012Local holdings: Available in print through MWHC library: 2007 onlyISSN:
  • 1553-5592
Name of journal: Journal of hospital medicine : an official publication of the Society of Hospital MedicineAbstract: BACKGROUND: Hospitalists often treat patients with severe acute hypertension (AH) presenting to the hospital. Little is known about the epidemiology of this syndrome.CONCLUSIONS: Severe AH appears common and its prevalence varies by underlying clinical condition. Severe AH is associated with excess in-hospital mortality for patients with nervous system diseases and, for most disease categories, prolongs hospitalization. Copyright 2011 Society of Hospital Medicine.DESIGN: A cohort study using retrospectively collected vital signs and other clinical data.MEASUREMENTS: Severe AH was defined as at least 1 systolic blood pressure (SBP) >180 mmHg. We used multivariable regression to estimate AH-attributable in-hospital mortality, need for mechanical ventilation (MV), and length of stay (LOS).OBJECTIVE: To examine the prevalence of severe AH in patients admitted through the emergency department (ED) and its associated outcomes.PATIENTS: A total of 1,290,804 adults admitted between 2005 and 2007.RESULTS: Severe AH occurred in 178,131 (13.8%) patients. Disease categories with the highest prevalence were nervous (29.0%), circulatory (16.0%), endocrine (14.7%), and kidney/urinary (13.5%). The overall in-hospital mortality was 3.6%. The relationship between severe AH strata and mortality was graded for nervous system diseases; mortality rates for each 10 mmHg increase in SBP from 180 to >220 mmHg were 6.5%, 8.1%, 9.9%, 12.0%, and 19.7%, respectively (P < 0.0001). The relationship between severe AH strata and need for MV was graded in the most pronounced way in respiratory and circulatory conditions (P < 0.0001). The relationship between severe AH strata and LOS was graded in most disease categories (P < 0.0001).SETTING: One hundred fourteen acute-care hospitals.All authors: Gupta V, Johannes RS, Shorr AF, Sun X, Tabak YP, Zilberberg MDFiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22038891 Available 22038891

Available in print through MWHC library: 2007 only

BACKGROUND: Hospitalists often treat patients with severe acute hypertension (AH) presenting to the hospital. Little is known about the epidemiology of this syndrome.

CONCLUSIONS: Severe AH appears common and its prevalence varies by underlying clinical condition. Severe AH is associated with excess in-hospital mortality for patients with nervous system diseases and, for most disease categories, prolongs hospitalization. Copyright 2011 Society of Hospital Medicine.

DESIGN: A cohort study using retrospectively collected vital signs and other clinical data.

MEASUREMENTS: Severe AH was defined as at least 1 systolic blood pressure (SBP) >180 mmHg. We used multivariable regression to estimate AH-attributable in-hospital mortality, need for mechanical ventilation (MV), and length of stay (LOS).

OBJECTIVE: To examine the prevalence of severe AH in patients admitted through the emergency department (ED) and its associated outcomes.

PATIENTS: A total of 1,290,804 adults admitted between 2005 and 2007.

RESULTS: Severe AH occurred in 178,131 (13.8%) patients. Disease categories with the highest prevalence were nervous (29.0%), circulatory (16.0%), endocrine (14.7%), and kidney/urinary (13.5%). The overall in-hospital mortality was 3.6%. The relationship between severe AH strata and mortality was graded for nervous system diseases; mortality rates for each 10 mmHg increase in SBP from 180 to >220 mmHg were 6.5%, 8.1%, 9.9%, 12.0%, and 19.7%, respectively (P < 0.0001). The relationship between severe AH strata and need for MV was graded in the most pronounced way in respiratory and circulatory conditions (P < 0.0001). The relationship between severe AH strata and LOS was graded in most disease categories (P < 0.0001).

SETTING: One hundred fourteen acute-care hospitals.

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